Reprodu??o & Climatério最新文献

During last years a delay of motherhood has been noticed. The increased incidence of cancer during lifetime and the increased survival rates of oncological diseases have contributed to a growing number of cancers detected during pregnancy which leads to the need for better knowledge about conception in these patients. Breast cancer is the most frequent type of cancer detected during pregnancy. About 40‐50% of breast cancer survivors want a subsequent pregnancy after treatment. We present a case of a primigravida diagnosed with breast cancer that conducted her first full term healthy pregnancy 2 years after diagnosis.

Objective

To make a review of studies that assessed the outcomes of GnRH agonist oocyte triggering in comparison with hCG in prevention of ovarian hyperstimulation syndrome and pregnancy rates.

Methods

A systematic review of studies presented in the following database: PUBMED, Lilacs and Scielo submitted from January 2005 to October 2015. The keywords were ovulation induction, ovarian hyperstimulation syndrome and gonadotropin releasing hormone.

Results

One hundred fifty-four articles were found. From these, twelve studies were completely analyzed. Eight fulfilled the inclusion criteria and one was included after the bibliographic review of the previous ones. From these nine submitted articles, two are retrospective and the others are prospective.

Conclusion

The use of GnRH agonist for oocyte triggering was comparable with hCG and showed low frequency of ovarian hyperstimulation syndrome.

Perimenopause is characterized by a decrease in sexual hormones and a reduction of their activities in the central nervous system, which results in neurological symptoms such as vasomotor dysregulation, mood alterations, sleep and cognition disorders. The literature is controversial about the timing and type of cognitive disorders related to perimenopause. Therefore, the aim of this study was to review the scientific literature to identify the period and the most common cognitive disorders related to the perimenopause. The databases Pubmed, Lilacs and Scielo were searched with the descriptors menopause, perimenopause and cognition. Considering the inclusion and exclusion criteria, nine articles were selected. The results showed that there is a direct relation between sexual hormones reduction and cognitive decline. Episodic, visual and verbal memories, verbal fluency, attention and processing speed were the most affected functions. However, most of the studies showed selection and diagnoses biases. In conclusion, the perimenopause is related to cognitive decline. It is important to highlight that because of the population ageing and consequent increase in the number of women in the perimenopause, the development of more robust studies is necessary in order to not only investigate the cognitive decline, but to also develop clinical and therapeutic approaches of success.

Introduction

Male infertility is characterized by the inability to produce sperm with normal concentration, motility and/or morphology, featuring an abnormal spermatogenesis. The diagnosis of male infertility is accomplished through spermogram.

Objectives

The present study aimed to verify the profile of male infertility of patients attended in an assisted human reproduction clinic.

Methods

We assessed the spermogram report of 196 patients who underwent semen analysis in a private clinic of assisted human reproduction, located in the south of the state of Santa Catarina (Brazil), from 2012 to 2014.

Results

32.7% of patients presented normal semen analysis, while 67.3% had some alteration in the report. Among the altered semen, the following diagnoses were found: teratozoospermia (44.7%), oligoasthenoteratozoospermia (20.5%), oligoteratozoospermia (15.9%), azoospermia (7.6%), asthenoteratozoospermia (6.8%), oligozoospermia (2.3%) and asthenozoospermia (2.3%). It was also showed that the sperm volume was modified with advancing age, showing a significant decrease in individuals over 40 years old.

Conclusions

our data revealed teratozoospermia as the most frequent sperm alteration found. Moreover, patients aged greater than or equal to 40 years old presented reduced sperm volume, although the patients’ age did not show correlation with the final diagnosis of the sperm analysis.

Aim

To review the published data on the association between maternal celiac disease and adverse pregnancy outcomes and its relationship to gluten‐free diet.

Sources

A systematic review of Biblioteca Virtual em Saúde (LILACS, IBECS, MEDLINE, SciELO, and Cochrane) and PubMed databases was performed. Cohort studies that compared the incidence of adverse pregnancy outcomes in women with treated and untreated celiac disease were included in the analysis. STROBE criteria was used to assess the internal validity of the studies.

Summary of the findings

Maternal untreated celiac disease was associated with premature births, low birthweight and small for gestational age. When celiac disease was treated, the risk of these outcomes was similar that found in people without celiac disease.

Conclusions

Untreated maternal celiac disease was associated with adverse pregnancy outcomes. Treatment with gluten‐free diet reduced significantly the risk of these outcomes, making the rate similar to that observed on women without celiac disease.

Objective

the purpose of this study was to analyze the association between menstrual disorders and QOL of the teachers of the Federal University of Rio Grande (FURG).

Methods

this is an observational, cross‐sectional and quantitative study. QOL was assessed by questionnaire called The Medical Outcomes Study 36‐ item Short Form Health Survey (SF‐36). In addition to this instrument was used a semi‐structured questionnaire, which asked about the other variables analyzed. The data were transferred to the package Stata version 11.2, where statistical procedures were performed by analysis of variance.

Results

the sample included 104 of 316 (32.9%) teachers working in campuses FURG in Rio Grande, RS, Brazil. As for data related to menstrual disorders, 42.3% (95% CI 32.7 to 52.0) of the sample already had abnormal menstrual cycle and only three participants performed hormone replacement therapy. The results showed that, for the domains vitality and emotional aspects, there was no association with changes in the menstrual cycle for any characteristic studied. In all other domains of the SF‐36 there was a higher QOL for women who did not have changes in the menstrual cycle.

Conclusions

menstrual disorder have negatively impacted the quality of life of teachers FURG.

Purpose

Conduct a review of the literature on smoking and use of oral contraceptives related to thromboembolic events, with presentation of the case of proximal thrombosis of the superior mesenteric artery and extensive necrosis of the small intestine in a female patient with probable coagulopathy caused by the association of oral contraceptive with smoking.

Materials and methods

This study consisted of a literature review, with selection of national and international scientific articles through research in PubMed, Lilacs and SciELO database.

Results

The relationship between the use of combined oral contraceptives and increased risk of thromboembolic disease is based on the procoagulant action of OCs, which translates into a risk factor for the occurrence of arterial and venous thrombosis. Smoking alone has moderately increased risk of venous thrombosis compared with non‐smokers. Besides that, there is a relation between the superior mesenteric artery thrombosis with the use of oral contraceptives associated with smoking.

Conclusion

All analysed studies have confirmed the use of OCs and smoking as risk factors for the development of thromboembolic diseases. The study based on the clinical history of the patient suggests a case of secondary arterial thrombosis coagulopathy by combining smoking with the use of combined OCs.

Medicinal plants are known as a prolific source of secondary metabolites which have important function both in vivo and in vitro during the ovarian folliculogenesis and steroidogenesis in many animal species. Some secondary metabolites can act as antioxidants generally through their ability to scavenge reactive oxygen species (ROS) or can regulate ovarian hormonal production. In general, these properties are responsible for the medicinal functions to treat woman infertility disorder. Some plants are constituted of biological actives substances which have been used to treat reproductive dysfunction. However, until recently, little was known about the implication of plants and/or their secondary metabolites on in vitro folliculogenesis and steroidogenesis. With the development of the technology, there is an increase implication of those substances in assisted reproductive technology (ART). The present review highlights some medicinal plants used in the treatment of woman disorders related to infertility. In addition, it provides an in vivo and in vitro overview of herbs and their active compounds with claims for improvement of ovarian activity thus showing their implication in female reproductive health care.

Breast cancer (BCAA) is one of the most frequent malignancies in women in several countries, which excessive exposure to oestrogens is one of the main risk factors. The ovaries are the main source of endogenous estrogen production; however, at menopause this production sessate and extra‐gonadal synthesis, especially in ectomesenchymal cells from adipose tissue, turns the main source of estrogen production, since these cells express aromatase, an enzyme that converts androgens to estrogens. Supported by strong clinical evidence androgen replacement has been recommended for the relief of symptoms caused by female syndrome of androgen insufficiency, such as fatigue, mood swings and depression; Furthermore, experimental studies have suggested the possibility of protection of androgen replacement against BCA. In these studies, acting through their receptors, testosterone showed antiproliferative, proapoptotic and inhibited the activity of estrogen receptors and growth of mammary tumors; Clinical evidence also support the protective role of androgens in the breast. However, studies indicate that this protective role depends on the level of aromatase activity; for instance, testosterone can exert a direct inhibitory effect on tumor growth by binding to its receptor, but have an indirect effect by stimulating its conversion to oestrogens by aromatase. Obesity and insulin, as well as multiple other factors, some of which are independent risk factors for BCA, may result in overexpression of aromatase, resulting in increased localized production of estrogens, which are inducible factors of BCA. Studies on the administration of testosterone in women are scarce and controversial, and there are no studies that provide data in terms of long‐term use of safety. Thus, in this review we intend to show how androgens act in the breast. Given the current evidence, the use of androgens in women with risk factors for breast cancer is not recommended.

The oocytes cryopreservation contributed substantially to a breakthough in Assisted Human Reproduction techniques over the last three decades. The methodology has been applied in the fertility preservation, through oocyte donation programmes, as strategy to reduce the number of supernumerary embryos cryopreserved by manipulating the least amount of fresh oocytes, and in the accumulation of oocytes in cycles with poor ovarian responders. Assuming the principle that every citizen has the right to health, it is the duty of the State to ensure access to all types of treatment. The Woman's Health Reference Center ‐ Pérola Byington Hospital has implemented the technique of oocytes vitrification since 2010, and has been improving our protocol continuously: aiming at improvements in the rates of survival, fertilization, cleavage and pregnancy. We reported the first two pregnancies, infants live born after oocytes vitrification, at our Center, proving the feasibility of the oocytes vitrification protocol applied, offering service to the public with equity and no cost for the patient.